摘要
目的评估超声引导下胸椎旁神经阻滞(US-TPVB)联合加巴喷丁治疗带状疱疹后神经痛(PHN)的临床疗效。方法回顾性分析2022年2月至2024年8月蚌埠医科大学第一附属医院收治的122例接受US-TPVB联合加巴喷丁治疗的PHN患者作为观察组,并选取同期122例仅接受加巴喷丁治疗的PHN患者作为对照组。比较两组患者治疗前及治疗后3个月的视觉模拟评分法(VAS)评分、匹兹堡睡眠质量指数睡眠质量(PSQI)评分、血清炎症因子[白细胞介素(IL-6)、肿瘤坏死因子-a(TNF-a)]水平、抑郁自评量表(SDS)评分及生活质量量表(SF-36)评分,并比较两组治疗期间不良反应发生率。结果治疗3个月后,观察组VAS、PSQI评分均低于对照组[(3.7±1.1)分比(4.2±0.9)分、(10.3±1.3)分比(11.1±1.3)分](P<0.01);观察组IL-6、TNF-a水平均低于对照组[(17±3)ng/L比(21±3)ng/L、(12.5±2.3)ng/L比(15.0±3.0)ng/L](P<0.01);观察组SDS评分低于对照组[(46.5±3.1)分比(49.5±4.0)分](P<0.01),SF-36评分高于对照组[(83.0±4.8)分比(80.1±3.9)分](P<0.01)。治疗期间,对照组药物相关不良反应发生率为12.30%(15/122),观察组为10.66%(13/122),两组比较差异无统计学意义(P>0.05)。此外,观察组出现US-TPVB相关轻微并发症5例,其中穿刺部位疼痛4例、局部皮下血肿1例,均为轻度。结论US-TPVB联合加巴喷丁可有效缓解PHN患者疼痛、改善睡眠质量,降低炎症反应,减轻抑郁状态并提升生活质量,其疗效优于单纯加巴喷丁治疗,且安全性良好。
Objective To evaluate the clinical efficacy of ultrasound-guided thoracic paravertebral nerve block(US-TPVB)combined with gabapentin in the treatment of postherpetic neuralgia(PHN).MethodsA retrospective analysis was conducted on 122 patients with PHN who received US-TPVB combined with gabapentinin the First Affiliated Hospital of Bengbu Medical University from Feb.2022 to Aug.2024,who were defined as an observation group,and 122 PHN patients treated with gabapentin alone during the same period were included as a control group.Visual analogue scale(VAS),Pittsburgh sleep quality index(PSQI),levels of serum inflammatory factors[leukocyte interleukin(IL-6),tumor necrosis factor-a(TNF-a)],the score of self-rating depression scale(SDS),and the short form 36 health survey scale(SF-36)of the two groups were compared before treatment and 3 months after treatment respectively,as well as the incidence of adverse reac tions during treatment.Results After 3 months of treatment,the VASand PSQI scores of the observation group were lower than those of the control group(3.7±1.1 vs 4.2±0.9,10.3±1.3 vs 11.1±1.3)(P<0.01);the levels of IL-6 and TNF-a in the observation group were both lower than those in the control group[(17±3)ng/L vs(21±3)ng/L,(12.5±2.3)ng/L vs(15.0±3.0)ng/L](P<0.01);the SDS score of the observation group was lower than that of the control group(46.5±3.1 vs49.5±4.0)(P<0.01),and the SF-36 score was higher than that of the control group(83.0±4.8 vs 80.1±3.9)(P<0.01).During the treatment period,the incidence of drug-related adverse reactions was 12.30%(15/122)in the control group and 10.66%(13/122)in the observation group,and there was no statistically significant difference between the two groups(P>0.05).In addition,there were 5 cases of mild complications related to US-TPVB in the observation group,including 4 cases of pain at the puncture site and 1 case of local subcutaneous hematoma,all of which were mild.ConclusionUS-TPVB combined with gabapentin can effectively relieve pain,improve sleep quality,reduce inflammatory response,alleviate depression and improve quality of life in PHN patients,and its efficacy is better than gabapentin alone,with good safety.
作者
朱安通
王一一
孔维健
徐多良
林学武
ZHU Antong;WANG Yiyi;KONG Weijian;XU Duoliang;LIN Xuewu(Department of Pain,the First Affiliated Hospital of Bengbu Medical University,Bengbu 233004,China;Department of Pain,Xinhua Hospital,Huainan Xinhua Medical Group,Huainan 232052,China)
出处
《医学综述》
2025年第21期2750-2754,共5页
Medical Recapitulate
关键词
带状疱疹后神经痛
超声引导
椎旁神经阻滞
影响因素
Postherpetic neuralgia
Ultrasound-guided
Paravertebral nerve block
Influencing factors
